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Individual

VERA LUCIA DE MATOS MAILLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-3247
(215) 590-3606
Mailing address
100 PENN SQUARE EAST 9TH FL NORTH TOWER, CHCA GASTRO, PHILADELPHIA, PA 19107
(267) 425-9500
(267) 425-9299

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
MD463234
PA

Other

Enumeration date
06/14/2007
Last updated
04/24/2018
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